A Qualitative Investigation of Space Exploration Medical Evacuation Risks.

INTRODUCTION: Exploration beyond low Earth orbit requires innovative solutions to support the crew medically, especially as the opportunity for timely evacuation to Earth diminishes. This includes assessing the risks and benefits that a complicated medical evacuation (MEDEVAC) poses to the injured crewmember, the crew, and the mission. This qualitative study identifies common MEDEVAC risk assessment principles used in spaceflight and other extreme environments to better inform future risk assessment tools and exploration mission concepts.METHODS: Semistructured interviews were conducted with subject matter experts in spaceflight and analog domains, including polar operations, undersea operations, combat medicine, and mountaineering. Transcripts were analyzed using the qualitative method of Thematic Analysis with the technique of consensus, co-occurrence, and comparison.RESULTS: Subject matter experts described 18 themes divided into two main categories: Primary Risk Considerations (e.g., crew, mission, resources, time) and Contributing Factors (e.g., psychological considerations, medical preparation, politics).DISCUSSION: Primary Risk Considerations can assess MEDEVAC risk across mission phases, with Contributing Factors acting as premission tools to adjust those risks. Inter- and intracategory connections identified medical support considerations, MEDEVAC support considerations, and philosophy as the most impactful Contributing Factors. Medical support considerations, psychological considerations, and political considerations were found to have unique aspects given the distances and societal impact of exploration vs. low Earth orbit spaceflight. The Contributing Factor theme of decision making was determined to be unique due to its impacts across both categories. These findings expand current considerations and are important inputs for exploration mission MEDEVAC Concepts of Operations.Almand A, Ko SY, Anderson A, Keller RJ, Zero M, Anderson AP, Laws JM, Lehnhardt K, Easter BD. A qualitative investigation of space exploration medical evacuation risks. Aerosp Med Hum Perform. 2023; 94(12):875-886.

Biologically-Based and Physiochemical Life Support and In Situ Resource Utilization for Exploration of the Solar System-Reviewing the Current State and Defining Future Development Needs.

The future of long-duration spaceflight missions will place our vehicles and crew outside of the comfort of low-Earth orbit. Luxuries of quick resupply and frequent crew changes will not be available. Future missions will have to be adapted to low resource environments and be suited to use resources at their destinations to complete the latter parts of the mission. This includes the production of food, oxygen, and return fuel for human flight. In this chapter, we performed a review of the current literature, and offer a vision for the implementation of cyanobacteria-based bio-regenerative life support systems and in situ resource utilization during long duration expeditions, using the Moon and Mars for examples. Much work has been done to understand the nutritional benefits of cyanobacteria and their ability to survive in extreme environments like what is expected on other celestial objects. Fuel production is still in its infancy, but cyanobacterial production of methane is a promising front. In this chapter, we put forth a vision of a three-stage reactor system for regolith processing, nutritional and atmospheric production, and biofuel production as well as diving into what that system will look like during flight and a discussion on containment considerations.